Feasibility and utilization of electronic patient-reported outcome measures for lung cancer in routine clinical care.

Authors

Ethan Basch

Ethan Basch

The University of North Carolina at Chapel Hill, Chapel Hill, NC

Ethan Basch , Huamao Mark Lin , Mary Lynn Cala , Melpomeni Styliadou , Aaron Galaznik , Debra Wujcik , Emelly Rusli , Nicholas C Coombs , Emily R Beamon

Organizations

The University of North Carolina at Chapel Hill, Chapel Hill, NC, Takeda Development Center Americas, Inc., Lexington, MA, Takeda Pharmaceutical Company Limited, Cambridge, MA, Takeda Pharmaceutical Company Limited, Zurich, Switzerland, Carevive Systems, Inc., Boston, MA, Piedmont Research Strategies, Billings, MT, Piedmont Research Strategies, Greensboro, NC

Research Funding

Takeda Development Center Americas, Inc.

Background: Prior studies have shown the value of Patient-Reported Outcomes (PRO) in cost burden, quality of life (QoL), and survival in cancer care. To facilitate focus on patient-centricity and value-based care, the International Consortium for Health Outcomes Measurements (ICHOM) and European Health Outcomes Observatory (H2O) developed a Core Outcomes Set (COS) in lung cancer. We explored the feasibility of deploying standardized PRO measures among patients with lung cancer in US clinical practice. Methods: A retrospective database study was conducted, with IRB waiver, using Carevive PROmPT, an electronic PRO (ePRO) remote symptom monitoring platform with weekly surveys comparable in scope to ICHOM/H2O COS, of symptomatic adverse events (PRO-CTCAE), physical function (PROMIS 4A Physical Function), and QoL items (EORTC QLQ-C30 items #29,30). Severe PRO-CTCAE symptom scores triggered care team alerts. From 9/2020 to 5/2023, 207 patients enrolled across 9 US cancer centers. Patients were ≥18 years, with lung cancer, and in current treatment. Patient engagement was measured by survey compliance, follow-up time, and completeness; clinician engagement was measured by platform utilization time, time to alert response, and clinical action taken. Results: Participants were 50% female, 86% White, 12% African American, median age 68, 81% NSCLC, and 26% with metastatic disease. Median survey persistence: 8 weeks, with 85% compliance over that time. Of domains assessed, 37 (58%) from Carevive data overlapped with ICHOM/H2O COS, with 19 measured over time. Overlapping domains included 15 clinical outcomes with 60% median completion rate and 22 PRO domains with 98% median completion. Of 19 domains assessed longitudinally, median compliance was 76%. Of patients triggering ≥1 ePRO symptom alert, 87% were within 4 weeks, with 46% requesting call-backs. Median clinician follow-up to alerts was 20 hours, with 69.3% addressed within 48 hours. Clinicians accessed the platform 2-3 times weekly, for median 2 minutes (range: 1-14 minutes) per login for nurses and Advanced Practitioners (AP). 89% of alerts were addressed by nurses and AP. Of alert responses, 66% indicated continuation of treatment, 12% were escalated to the clinical team, and 1% were escalated to hospitalization or ER visit. Conclusions: Results support the feasibility of integrating a standard set of multi-domain ePRO measures, comparable to the ICHOM/H2O COS, into routine cancer care, across multiple sites, with consistent patient engagement and provider utilization. One limitation is that clinical and financial impact were not directly assessed. Future research should explore direct clinician feedback, systematic implementation of PRO measures, and impacts on patient outcomes, resource utilization, and health systems.

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Quality Care/Health Services Research

Track

Care Delivery and Quality Care

Sub Track

Patien Reported Outcomes

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr 11107)

DOI

10.1200/JCO.2024.42.16_suppl.11107

Abstract #

11107

Poster Bd #

302

Abstract Disclosures

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